The remainder of this report provides a series of case studies of state or local initiatives designed to help caregivers eat better, increase physical activity and exercise, maintain a healthy weight, stop smoking, reduce alcohol use, improve sleep, reduce stress, identify available health resources, and increase their use of recommended clinical preventive services. By definition, a series of case studies does not yield a comprehensive list of such programs over time. Rather, we have focused largely on projects supported by the federal government or by the private sector (e.g., foundations) that illustrate, collectively, promising approaches and methods for achieving these goals.
We utilized several approaches to identify the initiatives. We first conducted an electronic literature search (http://www.ncbi.nlm.gov). We identified articles in the National Library of Medicine's Pub Med database by using combinations of the following terms: health promotion, disease prevention, caregiver, caregiver health, and caregiving. Next, we screened out all references to caregivers of small children or young adults. We also eliminated projects that had been completed before 1996 and/or were conducted in countries other than the United States. We then obtained and reviewed all relevant abstracts and articles (n=25).
Next, we held discussions with members of our technical expert panel to get specific leads on projects or literature (published or unpublished) and descriptions of any programs with which they themselves were involved. From these discussions, we were able to follow a "snowball" strategy of contacting yet other experts through several iterations. In all, we spoke with 25 individuals who could provide leads or information about promising caregiver health promotion activities. Finally, we conducted Internet searches to identify additional programs that may be too new to have generated any publications or received much attention to date.
It is important to note that the projects/initiatives described in the pages that follow are illustrative, not comprehensive, of the range of activities that are either currently underway or have recently been completed. There may be a number of efforts that have focused on the health and well-being of caregivers that went undetected by our multistage search strategy.